Could IVIM and ADC help in predicting the KRAS status in patients with rectal cancer?

  • Yanyan Xu
  • Qiaoyu Xu
  • Hongliang Sun
  • Tongxi Liu
  • Kaining Shi
  • Wu Wang
Gastrointestinal
  • 14 Downloads

Abstract

Purpose

To evaluate the diagnostic potential of DW-MRI relative parameters for differentiation of rectal cancers with different Kirsten rat sarcoma viral oncogene homologue (KRAS) mutation status.

Methods

Fifty-one patients with rectal cancer underwent diffusion-weighted MR imaging with eight b values. ADCs (including Max-ADC, Min-ADC and Mean-ADC) and IVIM parameters (D, pure diffusion; f, perfusion fraction; D*, pseudodiffusion coefficient) were respectively calculated by mono- and bi-exponential analysis. Patients were stratified into two groups: KRAS wild type and mutant. The DW-MRI-derived parameters between the KRAS wild-type group and KRAS mutant group were compared using the Mann-Whitney U test. Receiver-operating characteristic (ROC) analysis of discrimination between KRAS wild-type and KRAS mutant rectal cancer was performed for the DW-MRI-derived parameters.

Results

Max-ADC, Mean-ADC and D values were significantly lower in the KRAS mutant group than in the KRAS wild-type group, whereas a higher D* value was demonstrated in the KRAS mutant group. According to the ROC curve, Mean-ADC and D* values showed moderate diagnostic significance with the AUC values of 0.756 and 0.710, respectively. The cut-off values for Mean-ADC and D* were 1.43 × 10-3mm2/s and 26.58 × 10-3mm2/s, respectively.

Conclusion

Rectal cancers had distinctive diffusion/perfusion characteristics in different KRAS mutation statuses. The DW-MRI-derived parameters, specifically Mean-ADC and D*, show a moderate diagnostic significance for KRAS status.

Key Points

• Rectal cancers with different KRAS mutation statuses demonstrated distinctive diffusion/perfusion characteristics.

• Max-ADC, Mean-ADC and D values were lower in the KRAS mutant group.

• A higher D* value was demonstrated in the KRAS mutant group.

• IVIM-DW MRI may potentially help preoperative KRAS mutant status prediction.

Keywords

Rectal cancer Magnetic resonance imaging Diffusion Perfusion Mutation 

Abbreviations

ADC

Apparent diffusion coefficient

CRC

Colorectal cancer

D

Diffusion coefficient

D*

Pseudo-diffusion coefficient

DWI

Diffusion-weighted imaging

EGFR

Epidermal growth factor receptor

f

Perfusion fraction

IVIM

Intravoxel incoherent motion

KRAS

Kirsten rat sarcoma viral oncogene homologue

MRI

Magnetic resonance imaging

NCCN

National Comprehensive Cancer Network

ROI

Region of interest

ROC

Receiver-operating characteristic

TE

Echo time

TR

Repetition time

TSE

Turbo spin echo

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Hongliang Sun.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Yanyan Xu
    • 1
  • Qiaoyu Xu
    • 1
  • Hongliang Sun
    • 1
  • Tongxi Liu
    • 1
  • Kaining Shi
    • 2
  • Wu Wang
    • 1
  1. 1.Department of RadiologyChina-Japan Friendship HospitalBeijingChina
  2. 2.Philips HealthcareBeijingChina

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